Those affected by dementia arguably have the greatest need to quickly find, use, and safely exit a public toilet or a toilet within a shop or restaurant. But they face some of the greatest difficulties in doing so.

Inadequate toilet facilities have distressing consequences. They mean a lower quality of life for people with dementia, and increased levels of anxiety when out and about.

The negative impact of poor facilities

Many older adults avoid going about their everyday lives because of the lack and inaccessible nature of publically available toilet facilities.

Where public toilets are provided, poor design and signage are often barriers to independent use, particularly for people living with dementia.

For those living with dementia, the ability to live a normal life through day to day activities such as shopping or meeting friends in the community is affected. This can lead to social isolation, loneliness and a loss of independence.

Change within the community

Driving awareness of the need to make change is critical if the situation is to improve. Local authorities, retailers and businesses on the high street, community groups all have a part to play.

Public bodies such as local authorities even have a duty in law to make reasonable adjustments that mean people with conditions such as dementia are able to use their services, including when providing toilets.

Dementia Friendly Business Guide

Appropriate toilet provision and design varies widely but a range of help and information is available to make public facilities accessible and dementia friendly. By publicising the guidance already available we can all help to raise awareness of the current situation.

The Dementia Friendly Business Guide has information on ways to make toilets dementia friendly. These include the use of familiar or automatic flush systems, non-reflective surfaces, lighting, the contrast between doors and surroundings and clearly labelled taps and soap dispensers.

Small improvements make a big difference

Very simple and straightforward changes can also be made, like having clear entrance and exit signs. Toilet facilities lacking these can cause distress and embarrassment and a reluctance to use the facility in future.

Common examples include carers having to enter opposite-sex toilets to guide their partners out, or the person going through the wrong door and becoming lost.

A fire exit sign showing someone running with a directional arrow is also easily misunderstood as an exit sign. Similarly, doors that are both a fire exit and the route back to a public area can cause confusion.

Take action

The negative impact this issue can have on the lives of people affected by dementia cannot be overstated. Public and private sectors need to recognise the lack of dementia friendly toilet facilities as an important issue and to take prompt corrective action.

What is an inconvenient problem for most of us can be an insurmountable problem for those living with dementia – changes that help people with dementia make life easier for all.

Become a dementia friend – Learn more about what it is like to live with dementia and turn that understanding into action.

Toilet problems and continence – Read more information on our website about what causes problems with using the toilet and incontinence, and how they might affect a person with dementia.

This post was written by Alan Taylor, Programme Partnership Manager at Alzheimers Society and Angela Clayton-Turner, former carer for her husband who had dementia.

With thanks for content reproduced and adapted as published in the Lancet, August 2017 by Tales A, Burholt V, Nash P, Bichard JA, Clayton-Turner A; on behalf of 16 signatories. Dementia-friendly public toilets. Lancet 2017; 390: 552–53.

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Comments

I find using disabled toilets the best. Have learnt to only going to places that have them. If toilets are unsuitable or in a place which makes them inaccessible I complain to the manager. i find it is the large chains of restaurants are the worse culprits!!

Well done Ann. I too found it difficult taking my Mother out as she constantly wanted to go to the toilet, this was just part of her dementia problem.

Like you I used the disabled toilet for her as it was the only one with sufficient room for us both. I wouldn’t dare take her to a toilet where she could fiddle with a bolt and get herself trapped and become more distraught.

I am sorry to say that despite the wonderful work the Alzheimers Society does there is still alot of ignorance out there of dementia.

It has to be said that a lot of UK public toilets are in a dreadful state! I often need the loo in a hurry, and even finding a public toilet is usually a problem. Bad signs – or no signs at all… Locked toilets, even in ordinary shopping hours, and faults with doors, toilets, washbasins and taps…! Filthy toilets, no toilet paper, no washing facilities! Unpleasant and unhelpful personnel manning the toilets!

It has often put me into a right old panic. A big campaign is needed….